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Utah rates for HCPCS J9050

Carmustine 100 Mg (Special Coverage Instructions Apply. See Mcm: 2049)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$276.61 / $276.61 / $276.61
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$238.46 / $238.46 / $298.07
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$207.83 / $337.22 / $387.80
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$238.46 / $238.46 / $238.46
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$121.54 / $208.36 / $4,891.55
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$612.65 / $813.09 / $1,449.84
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$262.31 / $323.20 / $340.21
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$238.46 / $238.46 / $238.46